A case of Ischemic colitis occurring in chemotherapy for ovaryian cancer

Abstract

A case was a 60-year-old female patient. Based on the diagnosis of stage IIIc ovarian cancer, combination chemotherapy with paclitaxel and carboplatin (TC therapy) was performed. She had abdominal pain and diarrhea 10 days after the initiation of treatment, and was hospitalized. Contrast-enhanced CT performed at the day of hospitalization demonstrated dilatation of entire colon and accumulation of intestinal fluids, and colonoscopy revealed ulcerative lesions longitudinally scattered from the transverse through descending colon, leading to a diagnosis of ischemic colitis. Ischemic change attributed to paclitaxel treatment was suspected. Fasting and discontinuance of the chemotherapy resulted,in amelioration of the symptoms. Paclitaxel-induced mucosal damage associated with cell cycle arrest of epithelial cells, inhibition of vascular smooth muscle cell proliferation and migration, and inhibition of vascular endothelial cell accumulation are considered as underlying pathogenesis. In case of abdominal symptoms after the introduction of chemotherapy with taxane anticancer agents, it is important to suspect ischemic colitis for an appropriate diagnosis.